Correlates of Patient Safety Performance among Nurses from Hospitals with Less than 200 Beds

Sook Moon; Jia Lee

doi:10.7475/kjan.2017.29.4.393

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Moon and Lee: Correlates of Patient Safety Performance among Nurses from Hospitals with Less than 200 Beds

Original Article

Korean J Adult Nurs 2017;29(4):393-405.

Published online: 9 August 2017

DOI: https://doi.org/10.7475/kjan.2017.29.4.393

Correlates of Patient Safety Performance among Nurses from Hospitals with Less than 200 Beds

Sook Moon, MSN, RN¹, Jia Lee, Ph.D., RN^2,

¹Nursing Career Education Center-Seoul • Korean Nurses Association, Seoul, Korea

²College of Nursing Science, Kyung Hee University, Seoul, Korea

Corresponding author: Lee, Jia College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. Tel: +82-2-961-0894, Fax: +82-2-961-9398, E-mail: leejia@khu.ac.kr

- This research was partially supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education(2016R1A2B2016339).

Received 17 May 201726 July 2017 Accepted 22 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Although the patient safety is the first priority in hospitals, the safety strategies and supportive programs for nurses in medium and small-sized hospitals are still insufficient. The purpose of this study was to identify the correlates of patient safety performance related to characteristics of nurses working at small-medium sized hospitals with less than 200 beds.

Methods

The study design was a descriptive correlational design. Data were collected from 211 nurses of seven small-medium sized hospitals located in Seoul, Korea. Study variables measured by using survey questionnaires were patient safety performance, safety culture, job satisfaction, and general characteristics. Data were analyzed by multiple regression using SPSS/WIN 22.0 program.

Results

The strongest factor associated with patient safety performance was communication process (β=.21, p=.002) followed by working environment (β=.21, p=.008), satisfaction on job contents (β=.16, p=.033), and safety management manual in hospital (β=.12, p=.041). Among general characteristics, nurses unmarried, working as staff nurses, having more than 10 years of clinical experience, and working at hospitals with the first nursing grade performed better patient safety performance.

Conclusion

The study findings suggest that the small-medium sized hospitals require strategies for nurses, supportive working environment, clear job contents, and qualitative safety management manuals.

Keywords: Patient safety, Nurses, Job satisfaction, Hospitals

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Table 1.

General Characteristics of the Participants (N=211

Variables	Categories	n (%) or M± SD
Gender	Female	207(98.1)
Gender	Male	4(1.9)
Age (year)		31.40±6.63
	＜25	22(10.4)
	25~29	77(36.5)
	30~34	61(28.9)
	35~39	25(11.8)
	≥40	26(12.3)
Nursing education completed	Diploma	131(62.1)
Nursing education completed	≥ Bachelor	80(37.9)
Marital status	Married	65(30.8)
Marital status	Unmarried	146(69.2)
Job position	Staff nurse	163(77.3)
	Charge nurse	28(12.3)
	≥ Head nurse	20(10.4)
Years of clinical experience	＜2	19(9.0)
	2~＜5	63(29.9)
	5~＜10	76(36.0)
	≥10	53(25.1)
Years of experience at present unit	＜2	89(42.2)
	2~＜5	76(36.0)
	5~＜10	34(16.1)
	≥10	12(5.7)
Working hours per week	40~44	140(66.4)
	45~49	56(26.5)
	≥50	15(7.1)
Nursing grade of hospital		2.36±0.78
	1st grade	40(19.0)
	2nd grade	54(25.6)
	3rd grade	117(55.4)
Type of working unit	Medical unit	12(5.7)
	Surgical unit	137(64.9)
	Special unit	49(23.2)
	Others	13(6.2)
Number of patient safety education programs attended in the past 12 months	0	55(26.1)
	1	73(34.6)
	2	55(26.1)
	≥3	28(13.2)
Experience of healthcare accreditation	Yes	116(55.0)
Experience of healthcare accreditation	No	95(45.0)
Experience of incidence reporting	Yes	91(43.1)
Experience of incidence reporting	No	120(56.9)
Safety management manual in hospital	Yes	192(91.0)
Safety management manual in hospital	No	19(9.0)

Table 2.

Characteristics of Study Variables (N=211)

Variables	Categories	M± SD
Safety care activities	Falls (12 items)	4.46±0.47
	Patient safety education (5 items)	4.09±0.68
	Infection (9 items)	4.41±0.51
	Fire safety (4 items)	3.34±0.81
	Facility check (1 item)	4.00±0.87
	Patient identification (6 items)	3.59±0.47
	Communication (4 items)	2.36±0.80
	Medication (14 items)	4.31±0.54
	Blood transfusion (16 items)	4.65±0.49
	Total	3.88±0.38
Patient safety culture	Work/unit environment (18 items)	3.27±0.41
	Attitude of supervisor (4 items)	3.50±0.64
	Communication process (6 items)	3.46±0.51
	Frequency of events reported (3 items)	3.40±0.64
	Level of patient safety (1 item)	3.48±0.67
	Hospital management for patient safety (11 items)	3.31±0.49
	Total	3.40±0.39
	Number of events reported in the past 12 months (1 item)	0.72±1.57
Job satisfaction	Satisfaction on job contents (6 items)	3.32±0.53
	Satisfaction on working environment/employee benefits (6 items)	2.37±0.81
	Satisfaction on personnel management system (5 items)	2.87±0.63
	Satisfaction on colleague (4 items)	3.62±0.57
	Satisfaction on supervisor/manager (4 items)	3.56±0.62
	Total	3.16±0.43

Table 3.

Differences in Safety Care Activities, Patient Safety Culture, and Job Satisfaction by General Characteristics (N=211)

Variables	Categories	Safety care activities		Patient safety culture		Job satisfaction
Variables	Categories	M± SD	t or F (p) Scheffé	M± SD	t or F (p) Scheffé	M± SD	t or F (p) Scheffé
Gender	Female	3.88±0.38	0.51	3.41±0.39	2.12	3.14±0.41	1.24
Gender	Male	3.78±0.31	(.605)	3.00±0.21	(.035)	2.88±0.29	(.214)
Age(year)	＜25	3.73±0.25	1.34	3.31±0.33	-0.54	3.09±0.36	1.24
	25~29	3.86±0.36	(.256)	3.41±0.42	(.703)	3.11±0.45	(.294)
	30~34	3.88±0.39		3.41±0.38		3.14±0.39
	35~39	3.94±0.43		3.46±0.34		3.28±0.49
	≥40	3.95±0.36		3.41±0.31		3.24±0.38
Nursing education completed	Diploma	3.85±0.38	-1.23	3.39±0.41	-0.09	3.13±0.43	-1.19
Nursing education completed	≥ Bachelor	3.93±0.39	(.219)	3.40±0.37	(.937)	3.22±0.44	(.232)
Marital status	Married	3.84±0.36	-2.46	3.37±0.38	-1.74	3.12±0.42	-1.89
Marital status	Unmarried	3.97±0.40	(.015)	3.47±0.40	(.083)	3.24±0.43	(.059)
Job position	Staff nurse ^a	3.75±0.29	4.46	3.85±0.30	1.58	4.25±0.33	2.74
	Charge nurse ^b	3.35±0.64	(.013)	4.56±0.86	(.208)	3.76±0.71	(.067)
	≥ Head nurse ^c	3.63±0.81	a＞ b	2.55±0.57		4.27±0.29
Years of clinical experience	＜2 ^a	3.67±0.32	3.79	3.40±0.30	0.50	3.20±0.26	1.62
	2~＜5 ^b	3.87±0.32	(.011)	3.41±0.41	(.681)	3.10±0.44	(.185)
	5~＜10 ^c	3.85±0.36	a＜ d	3.36±0.39		3.11±0.41
	≥10 ^d	3.99±0.43		3.44±0.37		3.25±0.45
Years of experience at present unit	＜2 ^a	3.89±0.32	1.22	3.43±0.35	0.72	3.23±0.36	5.16
	2~＜5 ^b	3.82±0.37	(.300)	3.35±0.45	(.537)	3.02±0.47	(.002)
	5~＜10 ^c	3.96±0.47		3.43±0.34		3.28±0.43	a, c＞ b
	≥10 ^d	3.91±0.39		3.39±0.25		3.04±0.32
Working hours per week	40~44 ^a	3.89±0.37	1.24	3.46±0.35	5.19	3.21±0.42	4.26
	45~49 ^b	3.81±0.37	(.291)	3.28±0.42	(.006)	3.03±0.43	(.015)
	≥50 ^c	3.95±0.40		3.28±0.38	a＞ b	3.06±0.33	a＞ b
Nursing grade of hospital	1st grade ^a	4.12±0.65	3.74	3.52±0.46	5.66	4.56±0.72	5.09
	2nd grade ^b	3.44±0.46	(.025)	3.49±0.34	(.004)	4.02±0.54	(.007)
	3rd grade ^c	3.67±0.34	a＞ c	3.33±0.36	a＞ b＞ c	4.14±0.38	a＞ c
Type of working unit	Medical units	4.00±0.40	0.96	3.46±0.34	.36	3.16±0.50	1.25
	Surgical units	3.86±0.35	(.413)	3.40±0.37	(.777)	3.15±0.41	(.292)
	Special units	3.86±0.40		3.41±0.45		3.10±0.44
	Others	3.98±0.42		3.30±0.34		3.36±0.40
Number of patient safety education programs attended in the past 12 months	0	3.79±0.34	1.69	3.30±0.42	2.53	3.08±0.40	.0.76
	1	3.88±0.36	(.168)	3.48±0.39	(.058)	3.19±0.43	(.514)
	2	3.95±0.39		3.42±0.33		3.16±0.48
	≥3	3.87±0.39		3.33±0.34		3.18±0.31
Experience of healthcare accreditation	Yes	3.92±0.35	1.80	3.42±0.38	0.48	3.17±0.41	.0.56
Experience of healthcare accreditation	No	3.83±0.40	(.073)	3.39±0.39	(.630)	3.14±0.45	(.575)
Experience of incidence report	Yes	3.93±0.38	1.63	3.41±0.42	0.16	3.16±0.51	0.16
Experience of incidence report	No	3.84±0.37	(.104)	3.40±0.36	(.866)	3.15±0.35	(.868)
Safety management manual in hospital	Yes	3.90±0.37	2.77	3.41±0.39	1.04	3.17±0.43	1.16
Safety management manual in hospital	No	3.35±0.32	(.006)	3.32±0.39	(.299)	3.05±0.35	(.245)

Table 4.

Correlations between Safety Care Activities, Patient Safety Culture, and Job Satisfaction (N=211)

Variables		Patient safety culture							Job satisfaction						Safety care activities
Variables		1	2	3	4	5	6	Total	7	8	9	10	11	Total	Safety care activities
Patient safety culture	1	1
	2	.38^∗∗	1
	3	.44^∗∗	.40^∗∗	1
	4	.32^∗∗	.29^∗∗	.35^∗∗	1
	5	.38^∗∗	.33^∗∗	.40^∗∗	.23^∗	1
	6	.53^∗∗	.41^∗∗	.42^∗∗	.35^∗∗	.43^∗∗	1
	Total	.69^∗∗	.70^∗∗	.71^∗∗	.63^∗∗	.69^∗∗	.73^∗∗	1
Job satisfaction	7	.47^∗∗	.39^∗∗	.30^∗∗	.24^∗	.36^∗∗	.40^∗∗	.51^∗∗	1
	8	.37^∗∗	.14	.16^∗	.16^∗	.25^∗∗	.42^∗∗	.35^∗∗	.35^∗∗	1
	9	.39^∗∗	.33^∗∗	.20^∗	.18^∗	.16^∗	.39^∗∗	.39^∗∗	.40^∗∗	.51^∗∗	1
	10	.48^∗∗	.21^∗	.32^∗∗	.26^∗∗	.24^∗∗	.30^∗∗	.42^∗∗	.29^∗∗	.05	.17^∗	1
	11	.38^∗∗	.42^∗∗	.31^∗∗	.10	.26^∗∗	.34^∗∗	.43^∗∗	.45^∗∗	.23^∗	.31^∗∗	.42^∗∗	1
	Total	.61^∗∗	.42^∗∗	.37^∗∗	.27^∗∗	.37^∗∗	.55^∗∗	.60^∗∗	.71^∗∗	.70^∗∗	.73^∗∗	.53^∗∗	.69^∗∗	1
Safety care activities		.48^∗∗	.26^∗∗	.42^∗∗	.27^∗∗	.28^∗∗	.41^∗∗	.49^∗∗	.45^∗∗	.37^∗∗	.34^∗∗	.25^∗	.25^∗∗	.49^∗∗	1

1. Work/unit environment; 2. Attitude of supervisor; 3. Communication process; 4. Frequency of events reported; 5. Level of patient safety; 6. Hospital management for patient safety; 7. Satisfaction on job contents; 8. Satisfaction on working environment/employee benefits; 9. Satisfaction on personnel management system; 10. Satisfaction on colleague; 11. Satisfaction on supervisor/manager;

^∗ p＜.05,

^∗∗ p＜.001.

Table 5.

Correlates of Safety Care Activities (N=211)

Variables		B	SE	β	t	p
Marital status		-.04	.05	-.04	-0.69	.493
Safety management manual		.15	.08	.12	2.06	.041
Job position		-.10	.06	-.11	-1.63	.104
Years of clinical experiences		.02	.03	.05	0.74	.463
Nursing grade of hospital		-.02	.03	-.05	-0.72	.472
Patient safety culture	Work/unit environment	.20	.07	.21	2.69	.008
	Attitude of supervisor	-.03	.04	-.05	-0.70	.483
	Communication process	.16	.05	.21	3.10	.002
	Frequency of event reported	.02	.04	.03	0.52	.605
	Level of patient safety	.01	.04	.02	0.30	.761
	Hospital management for patient safety	.02	.06	.02	0.26	.798
Job satisfaction	Satisfaction on job contents	.11	.05	.16	2.14	.033
	Satisfaction on working environment/employee benefits	.05	.04	.10	1.39	.165
	Satisfaction on personnel management system	.07	.04	.12	1.69	.092
	Satisfaction on colleagues	.01	.05	.01	0.10	.917
	Satisfaction on supervisor	-.03	.05	-.05	-0.75	.455
		Adj. R²=.362, R²=.411, F=8.38, p＜.001

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